Herniated intervertebral disc: Nursing

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A herniated intervertebral disc refers to a bulging or protrusion of part of the intervertebral disc, which is rubbery cushion between the vertebrae of the spine. Herniated intervertebral discs are one of the most common causes of back pain.
First, let’s quickly review some anatomy and physiology. The bony spine, also known as the vertebral column, consists of 33 vertebrae that provide support for the head and protect the spinal cord. Between the vertebrae are the intervertebral discs, which are fibrocartilaginous structures that provide stability, allow spinal motion, and absorb shocks along the spinal column.
They have a central part called the nucleus pulposus, which is composed mostly of water, but also proteoglycans and some collagen. It provides volume for the disc, absorbs shock, and helps distribute weight and pressure evenly between the vertebrae. The tougher, outer part is called the annulus fibrosus, which is composed mostly of collagen fibers, but also some water and proteoglycans. It provides stability and protects the central nucleus pulposus.
Finally, there’s an anterior longitudinal ligament, which runs down the anterior surface of the vertebrae, and a posterior longitudinal ligament, which is much narrower and attached to the posterior surface of the vertebral bodies, and the intervertebral bodies.
Now, the spinal cord travels through the spinal canal and stops at the second lumbar vertebra. Here it ends in a cone, called conus medullaris. Since the spinal cord is shorter than the spinal canal, the nerves of the lumbar, sacral, and coccygeal regions have to travel down the spinal canal to reach their corresponding openings. In doing so, they form a nerve bundle below the spinal cord called the cauda equina.
Now, the main cause for herniated discs seems to be the daily stress applied to the spine throughout a client’s lifetime. Less commonly, herniated intervertebral discs can be caused by spinal trauma, connective tissue disorders, such as Ehlers-Danlos syndrome, and congenital defects of vertebral formation.